| East Metro - Maryland | |
|
911 Maryland Ave E Saint Paul MN 55106-2647 | |
| (651) 776-2719 | |
| (651) 771-3978 |
| Full Name | East Metro - Maryland |
|---|---|
| Speciality | Family Medicine |
| Location | 911 Maryland Ave E, Saint Paul, Minnesota |
| Authorized Official Name and Position | Paul Berrisford (CEO) |
| Authorized Official Contact | 6517721572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Metro - Maryland 2025 Sloan Pl Suite 35 Saint Paul MN 55117-2007 Ph: (651) 772-2077 | East Metro - Maryland 911 Maryland Ave E Saint Paul MN 55106-2647 Ph: (651) 776-2719 |
| NPI Number | 1104044692 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104044692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 1417 (Minnesota) | Primary |
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